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Clinics in Surgery

2017 | Volume 2 | Article 17851

Melanoma of the Esophagus: Endoscopic Findings of Superficial and Advanced Tumors

OPEN ACCESS

*Correspondence:Soji Ozawa, Department of

Gastroenterological Surgery, Tokai University School of Medicine,

Shimokasuya, Isehara, 259-1193, Japan, Tel: +81-463-93-1121, Fax: +81-

463-95-6491;E-mail: sozawa@tokia.ac.jp

Received Date: 15 Sep 2017Accepted Date: 20 Nov 2017Published Date: 30 Nov 2017

Citation: Koyanagi K, Ozawa S. Melanoma of

the Esophagus: Endoscopic Findings of Superficial and Advanced Tumors. Clin

Surg. 2017; 2: 1785.

Copyright © 2017 Soji Ozawa. This is an open access article distributed under

the Creative Commons Attribution License, which permits unrestricted

use, distribution, and reproduction in any medium, provided the original work

is properly cited.

Clinical ImagePublished: 30 Nov, 2017

Kazuo Koyanagi1 and Soji Ozawa2*1Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan

2Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan

Keywords Melanoma; Esophageal cancer

Clinical ImageWe present two cases of representative endoscopic findings of melanoma of the esophagus

(Figure 1) shows a superficial type of esophageal melanoma. A slightly elevated black pigmentation covering the esophageal wall entirely at 21 cm to 28 cm from the incisors is visible. Thoracoscopic and laparoscopic esophagectomy and cervical anastomosis using a gastric conduit were performed. Pathological examination and immunohistochemistry staining of the resisted specimens showed a melanoma of the esophagus with the depth of T1b-SM3 and no regional lymph node metastasis (Figure 2) shows a protruding advanced tumor surrounded by a superficial pigmentation of melanoma. Thoracoscopic and laparoscopic esophagectomy and a cervical anastomosis using a gastric conduit were performed. Pathological examination and immunohistochemistry staining showed melanoma of the esophagus with a depth of pT4a (adventitia) and regional lymph node metastasis.

Melanoma generally occurs on the skin of the whole body as a black pigmentation and rarely occurs in the digestive tract. In a previous study, Makuuchi et al. reported that the incidence of melanoma of the esophagus was 0.3% among all histological types of esophageal cancers in Japan and the prognosis was extremely poor [1]. Despite recent improvements in the outcomes of patients

Figure 1: Superficial esophageal melanoma. A slightly elevated black pigmentation is visible at 21‒28 cm from the incisors.

Figure 2: Advanced esophageal melanoma. Aprotruding tumor surrounded by a superficial pigmentation is visible.

Soji Ozawa, et al., Clinics in Surgery - Gastroenterological Surgery

Remedy Publications LLC., | http://clinicsinsurgery.com/ 2017 | Volume 2 | Article 17852

with melanoma based on the advances in molecular targeted drugs [1,2], surgical resection remains the mainstay of treatment strategies and neoadjuvant or adjuvant therapies have not yet been established for patients with esophageal melanoma. A multimodal therapeutic strategy is urgently needed to treat this desperate disease [3].

References1. Makuuchi H, Takubo K, Yanagisawa A, Yamamoto S. Esophageal

malignant melanoma: analysis of 134 cases collected by the Japan Esophageal Society. Esophagus. 2015;12(2):158-69.

2. Tapalian SL, Sznol M, McDermott DF, Kluger HM, Carvajal RD, Sharfman WH, et al. Survival, durable tumor remission, and long-term safety in patients with advanced melanoma receiving nivolumab. J Clin Oncol. 2014;32(10):1020-30.

3. Weber J, Mandala M, Del Vecchio M, Gogas HJ, Arance AM, Cowey CL, et al. Adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. N Engl J Med. 2017;377:1824-35.